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目的 研究Bcl 2 ,MDR1基因与儿童急性白血病耐药的关系及其临床意义。方法 采用逆转录多聚酶链式反应 (RT PCR)技术 ,对 36例急性白血病患儿及 10例血小板减少性紫癜患儿 (对照 )骨髓单个核细胞中Bcl 2和MDR1基因的表达进行检测。结果 ①初治组、复发组Bcl 2基因表达明显高于对照组 ,差异均有显著性(P <0 .0 5 )。初治组、完全缓解组Bcl 2基因表达明显低于复发组 ,差异均有显著性 (P <0 .0 1)。复发组MDR1基因的表达明显高于对照组、初治组、完全缓解组 (P <0 .0 1或 0 .0 5 )。初治组与对照组间及完全缓解组与对照组间的MDR1表达差异无显著性 (P >0 .0 5 )。②Bcl 2和MDR1基因的表达与白血病临床特征如性别、年龄、初诊时白细胞数、骨髓中幼稚细胞百分数及肝、脾、淋巴结肿大程度均无显著相关性 (P >0 .0 5 )。③Bcl 2与MDR1基因之间无显著相关性 (rs=0 .30 8,P>0 .0 5 )。结论 Bcl 2和MDR1基因可能通过不同的机制导致白血病的耐药。
Objective To study the relationship between the Bcl-2 and MDR1 genes and the drug resistance in children with acute leukemia and its clinical significance. Methods The expression of Bcl-2 and MDR1 genes in bone marrow mononuclear cells of 36 children with acute leukemia and 10 children with thrombocytopenic purpura (control) were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). Results ① The expression of Bcl-2 in newly diagnosed group and recurrent group was significantly higher than that in control group (P <0.05). The expression of Bcl-2 gene in primary treatment group and complete remission group was significantly lower than that in recurrent group (P <0.01). The recurrence group MDR1 gene expression was significantly higher than the control group, the initial treatment group, complete remission group (P <0.01 or 0.55). There was no significant difference in MDR1 expression between the newly diagnosed group and the control group and between the complete remission group and the control group (P> 0.05). The expression of Bcl-2 and MDR1 had no significant correlation with the clinical features of leukemia such as gender, age, white blood cell count, the percentage of immature cells in bone marrow, and the degree of liver, spleen and lymph node enlargement (P> 0.05). ③ There was no significant correlation between Bcl 2 and MDR1 (rs = 0.308, P> 0.05). Conclusion The Bcl-2 and MDR1 genes may cause drug resistance of leukemia through different mechanisms.